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Mental Health Parity Bills Move Toward Collision

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The House and the Senate are plowing ahead with work on bills that would require health plans, that cover mental health care, to apply the same rules to mental health care that they apply to other types of care.

Members of the Senate voted unanimously Tuesday to approve an amended version of S. 558.

The original parity bill would have kept states from establishing new parity rules that were stricter than the federal rules, but the amended version uses the existing federal Health Insurance Portability and Accountability Act floor preemption, according to Mila Kofman, a professor at the Health Policy Institute at Georgetown University.

The HIPAA preemption floor does permit states to establish parity laws that are stronger than the federal floor, Kofman says.

Members of the House Ways and Means Committee health subcommittee voted 10-3 Wednesday to approve another parity bill, H.R. 1424.

H.R. 1424, introduced by Rep. Patrick Kennedy, D-R.I., would require insurers that cover mental health services to cover all conditions in the Diagnostic and Statistical Manual-IV.

H.R. 1424 also would permit states to set their own, tougher mental health parity rules.

The House bill would allow participants in employer-sponsored health plans to respond to violations of parity laws by suing in state court for economic damages or other damages as well as for payment of claims, Kofman says.

Members of benefit plans govered by the Employee Retirement Income Security Act normally can sue only for payment of claims, Kofman says.

The Ways and Means health subcommittee rejected a substitute bill proposed by Rep. Dave Camp, R-Mich., that would have made H.R. 1424 more like S. 558.

The subcommittee approved a substitute version drafted by Rep. Fortney Pete Stark, D-Calif., the subcommittee chairman. That version changes the revenue provisions in the bill.

The House Education and Labor Committee already has signed off on H.R. 1424, and the House Energy and Commerce Committee also will be marking up the bill.

America’s Health Insurance Plans, Washington, joined groups such as the National Alliance on Mental Illness, Arlington, Va., in welcoming passage of S. 558.

“This bill provides coverage for persons with mental illness without undermining innovations in behavioral health services or imposing costs on employers that would make it difficult for them to continue to offer health care benefits,” AHIP President Karen Ignagni says.

Many insurance and employer groups, such as the American Benefits Council, Washington, are opposing parity bill provisions that would permit states to establish stricter standards could create enormous problems for insurers and employers.

Links to copy of Stark’s version of H.R. 1424 and documents discussing Stark’s version are available

CORRECTION: An earlier version of this article described the possible effects of S. 558, the Senate parity bill, on state parity standards incorrectly. The version of S. 558 passed by the Senate would permit states to set standards that were stricter than the federal standards.


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